No abstract

Midazolam, a short-acting benzodiazepine, has sedative, hypnotic, anxiolytic, amnestic and anticonvulsant effects. Given its advantages of rapid onset, short duration and low toxicity, midazolam is optimal for any procedural sedation. 1,2 The communication between healthcare providers and patients does not seem to be affected even with the use of midazolam in some cases; however, anterograde amnesia is beneficial in conscious sedation as it reduces unpleasant memories before or during the surgery. 3 The possibility of retrograde amnesia induced by midazolam has also been continuously presented in case reports 4,5 and in animal studies with probable mechanisms. 6,7 However, to our knowledge, there is no well-documented study about retrograde amnesia

Background:The role of intraoperative magnesium for the prevention of emergence agitation or delirium is unclear as there have been conflicting results reported by several randomized controlled trials. Aims:The aim of this study was to investigate the effect of magnesium sulfate on emergence agitation or emergence delirium in pediatric patients.Methods: Electronic databases, including PubMed, EMBASE, CENTRAL, CINAHL, Scopus, and Web of Science, were searched to identify studies which evaluated the effects of magnesium on postoperative emergence agitation or emergence delirium. The primary outcome was the incidence of emergence agitation or emergence delirium during the post-anesthesia stay. The secondary outcome was the agitation or delirium score upon admission to the post-anesthesia care unit. We estimated the odds ratio and standardized mean difference using a random-effect model. Results:A total of 712 pediatric patients from 10 randomized controlled trials were included in the final analysis. The incidence of emergence agitation or emergence delirium was 29.7% in the magnesium group and 50.5% in the control group. The pooled effect size revealed that the administration of magnesium sulfate significantly reduced the incidence of postoperative emergence agitation or emergence delirium in pediatric patients undergoing surgery with general anesthesia (Odds ratio, 0.31; 95% confidence interval, 0.15 to 0.64; p = .002). Additionally, children in the magnesium group reported significantly lower agitation or delirium scores than those in the control group (standardized mean difference, −0.70; 95% confidence interval, −1.15 to -0.24; p = .003). Conclusion:The administration of magnesium sulfate reduced the incidence and severity of emergence agitation or emergence delirium in pediatric patients after the use of general anesthesia during surgery.

Postoperative urinary retention (POUR) is a common complication after total knee arthroplasty. Currently, there are no clinical data regarding the effects of magnesium sulfate on POUR. Here, we investigated the effects of intraoperative magnesium sulfate infusion in patients with POUR following total knee arthroplasty. We reviewed the medical records of patients who underwent elective unilateral total knee arthroplasty under spinal anesthesia between June 2016 and May 2018. The patients were grouped based on whether they were treated with magnesium (magnesium group) or not (control group). We investigated the incidence of POUR and the postoperative analgesic requirement. Totally, 483 patients were included in the analysis. After propensity score matching with the control group, the magnesium group showed a lower incidence of POUR (odds ratio, 0.49; 95% CI, 0.29–0.83; p = 0.011) and lesser opioid consumption (p = 0.049) than the control group. Multivariate logistic regression analysis revealed that intraoperative continuous infusion of magnesium (p = 0.008) and age (p = 0.001) were significantly related to the incidence of POUR. This retrospective observational study demonstrated that administration of magnesium sulfate was associated with a lower incidence of POUR following total knee arthroplasty.